Governor’s race | Becky Hultberg | Budget

We’ve got a little health policy on our list this month, but April’s newsletter is more about the content happening around the policy talk. We are tracking the idea of “re-building trust,” the comings and goings of folks in the system, and some interesting collaborations.

Next month, we host our Convening Panel for our fall conference. So if you have content and panel ideas for what Alaska’s health care system should be discussing come fall, now’s a good time to drop me a note!

1.  Medicaid rates likely down sharply

To help the legislature find cost savings in the budget, the Administration is working to cut professional rates about 12% down to Medicare+15%.  Hospitals will be cut about 5%. However, it’s likely the legislature will make budget cuts that will drive even more reductions in rates.

The House has passed an income tax package, something building through Walker’s term, some argue. However, I think it’s hard to see the votes for that in the Senate. That chamber is getting creative in its accounting of cuts.

Meanwhile, Rep. Spohnholz’s transparency legislation moved forward (HB 123) having passed the House 34-6. HB 191 loosens the education required for osteopaths to be licensed in Alaska. HB 193 was newly introduced and disallows balance billing for providers of patients that are otherwise covered by insurance.

2.  APU & ANTHC: Potentially a big deal

The partnership announced between Alaska Pacific University and the Alaska Native Tribal Health Consortium could become a significant factor in solving a workforce shortage in Alaska health care. The school is working to become designated as a tribal college.

Bob Onders is serving as the Interim President. LeAnn Garrick is the Chair of the Board. Both come deeply steeped in health care at ANTHC. I’d expect to see APU develop a pool of mid-level provider talent, with strong cultural competency. And by addressing some of the work force issues in Alaska’s health care, it’s possible utilization and costs will be partially mitigated as well, over time.

3.  “Rebuilding the public trust”

Becky Hultberg is one of the smartest people in Alaska healthcare, a comment I’ve made before and will likely make again.  At the recent Alaska MGMA Annual Meeting, her slide deck had folks sitting up straight and paying close attention.  During that presentation, she made the closing comment that the health care sector needed to work on re-building trust with the public regarding the costs of services provided by the industry.  It was a strikingly honest comment, and she was kind enough to let me follow up with some questions.

From our discussion:  “There is a growing public concern about cost. And we have to address the issue of cost because people also have to trust that when they come to us, they’re going to get good value for the money they and their insurer are spending.”

4. UAA: Bill Hogan and Jeff Jessee

Bill Hogan is one of Alaska’s wise men when it comes to health care, having served in a number of capacities at DHSS, UAA, the Mental Health Trust Authority and in the Mat-Su. He is currently the Dean of the College of Health at UAA but is retiring soon. He tells me he looks forward to some consulting work in Alaska and nationally, and winters in his new home in Florida.

Jeff Jessee will take his spot, one of the few folks that can ably and immediately fill Bill’s shoes.  Jeff has spent his recent career building the Trust into one of the most important players in Alaska health policy. I expect he’ll bring that same energy and leadership to UAA.  Jessee says: “I’m excited to have the opportunity to help the College of Health ensure that we are growing our own and ensuring that Alaskans are prepared to take these jobs.”

5.  Poll: Bill Walker, Joe Miller, and Mark Begich is reporting poll numbers on the 2018 gubernatorial campaign. If Gov. Walker faces a crowded field in a Republican primary, Walker faces a plausible but uphill battle against “everyone’s favorite beard” Joe Miller. One on one, Miller is up 33-21%, leaving 46% of respondents undecided. If Miller gets out, however, Walker looks like he has a relatively clear path to the nomination, up 25% in a 5-way field.  On the Democratic Party side, Mark Begich is the clear front-runner among potential candidates included in the poll, starting with 42%.

My guess is if Walker runs and wins the Republican primary, and Begich wins the Democratic Primary, Joe Miller could play spoiler to Walker if he runs as a third party candidate following the primary.  If Miller and Begich win the primary and Walker runs as a third party candidate, Walker might play spoiler to Miller. Both three way options look good for Begich, with both two-candidate options likely leaning Republican.